Haematemsis

Diagnosis:

-First make sure that it is vomiting of blood not coughing up of blood (Haemoptysis).

-Ask about melena.

-Esophageal varices: old patient- history of liver disease- lax abdomen.

-Perforated peptic ulcer: young patient- history of gastric troubles- rigid abdomen.

Differential Diagnosis:

-Esophageal Varices

-Perforated Peptic Ulcer

-Acute Erosive Gastritis 

-Mallory Weiss Syndrome 

-Hiatus Hernia

Treatment: 

Give: Glucose 5% solution, Ringer or saline solution + haematemesis cocktail  

Haematemesis cocktail consists of :

1-Dicynone ampule

2-Haemostop ampule

3-kapron ampule 

1&2&3 in the solution

4-vitamin k ampule intramuscular (Konakion ampule)

NB:

-Slow haematemesis (bleeding) : coffee ground.

-It is very important to differentiate between haematemesis and haemoptysis.